The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction.

BACKGROUND

Fetal growth restriction (FGR) is characterized by the fetus's inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflammatory diet can cause chronic inflammation and, Dietary Inflammatory Index (DII) was developed to evaluate of the diet's impact on inflammation. A high DII indicates a pro-inflammatory diet, known to increase serum inflammatory markers, with oxidative stress playing a key role in inflammatory diseases. The study aimed to investigate the correlation between maternal DII, total oxidant status (TOS), total antioxidant status (TAS), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels in FGR-diagnosed pregnant women.

METHODS

This prospective-observational study included FGR-diagnosed pregnant women and healthy pregnant women with gestational ages of 32-38 weeks (n = 23 per group). Chronic diseases, hypertension, fetal anomalies, membrane ruptures, and multiple pregnancies were excluded. The DII was calculated using the BeBiS-9 program based on 3-day dietary records kept by an expert dietician. Blood samples were collected, centrifuged, and analyzed for IL-6, TNF-α, IL-10, TAS, and TOS.

RESULTS

The study group had significantly higher DII scores (p < 0.001), lower energy (p = 0.004), carbohydrate (p = 0.002), protein (p = 0.011), fiber (p < 0.001) intake than the control group. TNF-α levels were elevated in the FGR group (p < 0.001), while IL-6 levels were higher but not statistically significant (p = 0.06). IL-10 levels were lower in the study group (p = 0.05). TAS, TOS, and TAS/TOS levels showed no significant differences between groups. Logistic regression indicated a 62% increase in FGR probability with higher DII levels (p = 0.001, CI 1.209-2.195). Correlation analysis revealed a strong positive correlation between DII and maternal serum TNF-α (r = 0.375, p = 0.01) and a strong negative correlation between birth weight and TNF-α (r=-0.478, p < 0.001) and DII (r=-0.446, p = 0.002).

CONCLUSION

This study showed that a pro-inflammatory maternal diet increased dietary inflammatory index and increased maternal inflammatory markers, and this was more significant in fetuses with FGR than in normal weight fetuses.